Dear Lactnetters:
I am a certified childbirth and breastfeeding educator ( working toward my
IBCLC ) out here in  West Texas. One of the moms I have been working with has
asked me  the following questions. But first some hx. -- He is now 5 1 / 2
 mo old,  wt.15 lb,  Mom was a gestational diabetic, Normal vaginal del.
,birth wt. 6.14 . Flown to Dallas due to hypertension and he spent 6 weeks in
NICU for hypertension and developing severe stomach infection after
 receiving expired  formula ( this mom was pumping  and  the staff
supplemented w/ formula with out consulting with her ) final dx- renal vein
thrombosis and  hypertension - Right kidney is non- functioning and not
growing.  Left kidney is functioning and increasing in size apparently  to
compensate for the nonfunctioning kidney. Medications for the hypertension
include: Captopril, Nifedipine, Hydrolozine and sodium acetate. Digitalis may
be started at next cardiologist consult due to borderline heart enlargement.
( due to hypertension ?? ) Baby may also have the non-functioning kidney
removed in several months to see if this helps his hypertension.
She commutes to Dallas every month to see the pediatric cardiologist  and
kidney specialist in addition to weekly b/p check and monthly checkups with
the local  Neonatologist . She knows of only one other baby with this
condition, but has not talked to the mom. This is  a rare condition. Cause??
At last month's  checkup the Neo. told her that with a baby at this age she
would not be able to provide all the nutrition ( calories) he would need with
just  breastmilk    and needed to begin rice cereal, then add fruits & veges.
She added rice cereal and several days later he developed severe vomiting and
diarrhea which sent him to the ER. After getting well she offered it again,
same result ( no ER  visit this time). Neo's nurse said it was an allergy and
next time try oatmeal. (Interesting side note: she offered him a spoonful of
cow's milk while eating cereal late one night and visiting  with her sister .
He reacted with vomiting and diarrhea) She has delayed offering any more
until she feels he is ready--Smart Mom !!- Baby nurses every 2 hours ,sleeps
all night, sometimes uses breast for comfort, happy personality, pees & poops
okay.

Now questions:

1. Could the medications cause or have the side effect of slowing or reducing
rate of weight gain.? - He only gained 1/2 lb in 1 mo. So supplemental foods
were started,  I don't know which type of growth chart the Neo is using.

2. She does not want him to have bottles  so would a SNS with EBM and
fortifier / formula be an option ? The statement about"  her milk not having
enough calories for him at this age"  really upset her.

3. Have any of you worked with a baby with this Dx. ? If so what else
can/should we be doing. What is the usual outcome?

I am so proud of this young mom. She has had to overcome many obstacles.
Any suggestions or help will be appreciated. You may post to the group or
Email me privately - [log in to unmask]

Thanks in advance,
Leslie Andrews RN, ICCE
Abilene, Texas